“I hate the feeling of it,” the patient adamantly stated as we recommended she start wearing sunscreen to protect herself and her young daughter. She went on to describe the thick white streaks left on her skin after application and how it never seemed to blend in well with her skin tone. As dermatologists, we are not oblivious to the reasons why, despite widespread public health awareness campaigns, some patients still do not want to wear sunscreen. Now, there are also increasing social media misconceptions about sunscreen—particularly regarding who needs to use it, efficacy against preventing skin damage, and its potential side effects. Misconceptions can lead to consequences, including an increased risk of skin damage and skin cancer. It is important to understand that sunscreen is essential for everyone, regardless of skin color.

Understanding Skin Cancer Risk

In our clinics and in Mohs surgery, we have seen patients of all races and ethnicities get skin cancer. Although it is reported that patients with darker skin have a decreased risk of skin cancer compared to those with lighter skin, they have a higher risk of morbidity and mortality from skin cancer. Further, skin cancer in people with darker skin tones is often diagnosed at a more advanced stage, leading to poorer outcomes and larger skin cancer sizes. According to the Skin Cancer Foundation, Black patients with melanoma have an estimated five-year melanoma survival rate of 71% vs 94% for white patients.

The Role of Sunscreen

Sunscreen plays a significant role in protecting the skin from harmful ultraviolet (UV) radiation. UV rays can damage DNA in the skin cells, leading to the development of skin cancer. UV radiation is harmful to the skin, regardless of whether it comes from natural sunlight, or artificial UV from and has been identified as a carcinogen by the World Health Organization tanning beds. Also, UV exposure can lead to formation of dark spots or hyperpigmentation and early signs of aging.

Popular Sunscreen Misconceptions 

“Sunscreen is harmful and full of chemicals.” There are many people discussing the potential harms of sunscreen in social media. Although some who are concerned about the ingredients in sunscreen, there are many formulations available. A great formulation such as mineral sunscreen uses zinc oxide or titanium dioxide, which are considered safe and effective. When the physical sunscreen particles are broken down into smaller pieces (micronized), the sunscreen may also be easier to wear.

“Darker skin doesn’t need sunscreen.” False. Melanin provides some protection against UV radiation, but it is not enough to prevent skin damage, hyperpigmentary disorders, and, and in some cases, cancer. Sunscreen helps to provide additional protection. Some sunscreens that are less likely to leave a thick white film are ones such as Black Girl Sunscreen, LaRoche-Posay Toleriane Double Repair UV SPF Moisturizer, Cerave Hydrating Sheer Sunscreen, Neutrogena Hydroboost, and EltaMD UV Clear. Also some sunscreen makers have different tinted shades that blend in better with different skin tones. 

“Sunscreen is only necessary on sunny days.” False. UV radiation penetrates clouds even when it is cloudy so we suggest patients still wear sunscreen on these days. 

“More expensive sunscreen offers better protection.” False. The protective quality of sunscreen is depended on the SPF number. Excellent sunscreens can be found at an economical price. 

Recommendations for Sunscreen Use

• Broad-Spectrum Protection: Choose a sunscreen that offers broad-spectrum protection against both UVA and UVB rays.
• SPF 30-50 or Higher: Most people do not use a large enough volume of sunscreen to obtain the SPF number on the bottle. Therefore, we recommend using a sunscreen with a high SPF to make sure you are getting adequate protection 
• Consistent Application: Apply sunscreen generously and reapply every two hours, or more often if swimming or sweating.
• Everyday Use: Make sunscreen application an easy daily habit. Put in near the door or near your bathroom counter where you can see it and integrate it into your routine—maybe next to your deodorant!
• Explore Formulations: Some prefer spray on or creams while children may be more independent with roll-on or sunscreen sticks.

As dermatologists, we want to help dispel the myths about sunscreen use to prevent skin damage and reduce the risk of skin cancer across all populations. By understanding the importance of sunscreen and adopting it into daily routines, everyone, regardless of background, can protect their skin and enjoy better long-term health.

For more information on the importance of sunscreen and skin cancer prevention, please visit the American Academy of Dermatology’s website or consult with a dermatologist at the University of Iowa.